Number of Uninsured Children Increases by 400,000

https://www.thefiscaltimes.com/2019/10/30/Number-Uninsured-Children-Increases-400000

A new report from the Georgetown University Health Policy Institute says the number of uninsured children in the U.S. increased by more than 400,000 between 2016 and 2018.

Some key findings from the report:

  • The number of uninsured children rose above 4 million by the end of 2018.
  • Insurance coverage losses are concentrated in 15 states — Alabama, Arizona, Florida, Georgia,
  • Idaho, Illinois, Indiana, Missouri, Montana, North Carolina, Ohio, Tennessee, Texas, Utah, West Virginia.
  • States that have not expanded Medicaid, as allowed by the Affordable Care Act, have seen much larger increases in uninsured rates.
  • Children in non-expansion states are nearly twice as likely to be uninsured compared to states that have expanded Medicaid.
  • White and Latino children saw the largest increases in the uninsured rate.
  • Households with low to moderate income – $29,000 to $53,000 per year for a family of three – were the hardest hit.

The report’s authors said it’s no coincidence that the increases in the number of uninsured children have occurred since President Trump took office in 2017.

“This serious erosion of child health coverage is likely due in large part to the Trump Administration’s actions that have made health coverage harder to access and have deterred families from enrolling their eligible children in Medicaid and CHIP,” they wrote in their conclusion. “These actions include attempting to repeal the ACA and deeply cut Medicaid, cutting outreach and advertising funds, encouraging states to put up more red tape barriers that make it harder for families to enroll or renew their eligible children in Medicaid or CHIP (or ignoring it when they do), eliminating the ACA’s individual mandate penalty, and creating a pervasive climate of fear and confusion for immigrant families.”

 

 

 

 

CFO of Children’s Health in Dallas steps down; 2nd finance leader to leave in a month

https://www.beckershospitalreview.com/hospital-executive-moves/cfo-of-children-s-health-in-dallas-steps-down-2nd-finance-leader-to-leave-in-a-month.html?origin=cfoe&utm_source=cfoe

Image result for children's health in dallas

Rich Goode, vice president and CFO of Dallas-based Children’s Health, resigned Sept. 24, about a month after another finance leader left the organization, according to The Dallas Morning News.

Hospital officials did not give a reason for his departure. The organization has not responded to Becker’s request for comment.

Mr. Goode’s resignation comes after the August departure of Ryan Bailey, head of investments at Children’s Health, who left to form an investment firm.

Mr. Goode served as CFO for three years, joining Children’s Health in 2016. He was previously vice president of finance and CFO at Cook Children’s Health Care System in Fort Worth, Texas.

Mr. Goode is credited with doubling the system’s net operating income and implementing analysis tools to offer better insights into its financial health during his tenure.

 

Federal appeals court limits hospitals’ disproportionate-share funding

https://www.modernhealthcare.com/payment/federal-appeals-court-limits-hospitals-disproportionate-share-funding?utm_source=modern-healthcare-daily-finance-wednesday&utm_medium=email&utm_campaign=20190814&utm_content=article1-headline

Hospitals that care for a large share of Medicaid, low-income and uninsured patients stand to receive less funding from the federal government after the D.C. Circuit reconsidered how Medicaid disproportionate-share hospital reimbursement is calculated.

A three-judge panel of the U.S. Court of Appeals for the District of Columbia Circuit reversed a lower court and reinstated a 2017 rule establishing that payments by Medicare and private insurers are to be included in calculating a hospital’s DSH limit, ultimately lowering its maximum reimbursement.

In Tuesday’s ruling, U.S. Circuit Judge Karen LeCraft Henderson opined that the rule aligns with the intent of the Medicaid Act.

“By requiring the inclusion of payments by Medicare and private insurers, the 2017 rule ensures that DSH payments will go to hospitals that have been compensated least and are thus most in need,” Henderson wrote.

The case, brought by four children’s hospitals in Minnesota, Virginia and Washington and an association representing eight children’s hospitals in Texas, concerns the calculation of the uncompensated costs of treating Medicaid beneficiaries known as the “Medicaid shortfall.

For instance, if a hospital spends $1 million on treating Medicaid patients who have no other healthcare coverage and Medicaid pays $600,000, then the Medicaid shortfall is $400,000. In some instances, Medicaid patients have additional third-party coverage such as Medicare or private insurance.

Hospitals cannot receive more money in Medicaid DSH payments than they spent to treat Medicaid beneficiaries or the uninsured. Part of the motivation behind that stipulation was to prevent hospitals from double dipping by collecting DSH payments to cover costs that had already been reimbursed. Previous cases also revealed that some states have made DSH payments to state psychiatric or university hospitals that exceed the net costs, or even total costs, of operating the facilities.

Providers successfully fought the 2017 rule that limited hospitals’ reimbursement. A federal judge sided with the hospitals that claimed the CMS overstepped its authority and essentially ignored payments by commercial insurers and Medicare. That was overturned Tuesday.

The Children’s Hospital Association of Texas said in a statement that it is exploring its options.

“We are disappointed with the result because it will reduce critical Medicaid funding to safety net providers like children’s hospitals,” the association said. “These hospitals are heavily reliant on Medicaid payments because between 50% and 80% of their inpatient days are covered by Medicaid. Children’s hospitals care for all children, and are, in fact, often the only place that children with complex conditions can get life-saving care.”

 

 

 

Why Are at So Many Children Losing Medicaid/CHIP Coverage?

Why Are at So Many Children Losing Medicaid/CHIP Coverage?

Along with the American Academy of Pediatrics, First Focus and Children’s Defense Fund, Georgetown University CCF held a press tele-conference and released a report examining an alarming trend in children’s health coverage. The report shows that more 800,000 fewer children had Medicaid/CHIP coverage at the end of 2018 compared to 2017. This trend comes amid broader efforts to restrict access to health coverage and discourage participation by legal immigrants.

The report found little evidence to support claims that the improving economy was responsible for the 2.2 percent decline in enrollment. Instead data suggest this 2018 could be the second year in a row that the rate of uninsured children increases. The U.S. Census Bureau will release the 2018 child uninsured rate data later in the fall.

Enrollment declines are concentrated in seven states – California, Florida, Illinois, Missouri, Ohio, Tennessee, and Texas – which account for nearly 70 percent of the losses. Nine states – Idaho, Illinois, Maine, Mississippi, Missouri, Ohio, Tennessee, Utah, and Wyoming – had decreases of more than double the national average.

Please listen to the recording of the press call or read the report for more details. Here a few excerpts from Thursday’s press conference:

Joan Alker of CCF moderated the call and explained why this drop in child enrollment is so alarming.

“We are extremely concerned about what we are seeing and what it portends for the uninsured numbers these fall,” she said. “For many years there’s been a national bipartisan commitment to reduce the number of uninsured children and the effort have borne fruit. Unfortunately, today we do not feel confident that this national commitment still exists.”

Tricia Brooks, lead author of the report, explained the many factors have likely led to the decline in child enrollment.

“Knowing that the economy had a minimal impact at best, we must call on state and national policymakers to address the factors contributing to the enrollment decline,” said Brooks. “From systems and renewal issues to enrollment barriers to threats like public charge, we must take a hard look at what these administrative actions and barriers to coverage mean for our kids’ health.”

Dr. Laura Guerra-Cardus, Deputy Director for the Children’s Defense Fund of Texas  said overly cumbersome eligibility checks are causing thousands of eligible children to lose coverage in her state. Nine out of every 10 Texas children being dropped are losing coverage due to red-tape. She said this is causing significant confusion for families and throughout the Texas health care system as many families don’t learn their children are uninsured until they show up for an appointment with their health care provider.

“These income checks are erroneously flagging families – at the very least 30% of the time. Families are not being given enough time to respond,” she said. “They are given only ten days to respond and the timeline starts once flagged by the system which could be before the parents even receive notification.”

Bruce Lesley, President of First Focus, pointed out that bipartisan legislation in the U.S. Congress would address the issues raised by Dr. Guerra by requiring 12 months continuous health coverage for children. He also cited polls that show strong support for children’s health coverage in general.

“The American public is with us on this. Kids are a priority but we’re seeing a failure of policymakers to adhere to what voters want and make children a priority,” Lesley said.

Dr. Lanre Falusi, a pediatrician at the Children’s National Health System and national spokesperson for the American Academy of Pediatrics said pediatricians are very concerned about the decline in Medicaid and CHIP enrollment. In addition to cumbersome enrollment process and administrative burdens discouraging families from enrolling eligible children, she pointed out that immigrant families also encounter the chilling effect the proposed public charge rule.

“The public charge proposal presents immigrant families with an impossible choice: keep your family healthy but risk being separated or forgo vital services like Medicaid so your family can remain together in this country. Although the final rule has yet to be issued, the proposal has already caused immigrant families to avoid or even disenroll from programs they are eligible for out of fear, like Medicaid. I have seen this myself,” Dr. Falusi said.

“We need all children in the United States to reach their full potential if we are to reach ours as a nation. Ensuring children are enrolled in health coverage designed to meet their needs is necessary to making that possible. Our lawmakers must pass policies that keep programs like Medicaid and CHIP strong, not those that jeopardize the critical gains we’ve made in children’s coverage.”